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Janet R. Hardy

and Columba Quigley

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date: 18 June 2021

Chapter 16 discusses Diamorphine (di-acetyl morphine, heroin), a semisynthetic derivative of morphine. It is not an active drug in its own right, but a pro-drug or opioid delivery system. The active metabolites 6-monoacetylmorphine (6-AM) and morphine are responsible for the analgesic effects of the drug. Diamorphine was first produced commercially in the late 1890s as a treatment for a variety of respiratory conditions including dyspnoea, pharyngitis, laryngitis, bronchitis, asthma, and tuberculosis. It was marketed by the Bayer Company under the trade name ‘heroin’. It was also recommended as a remedy for morphine dependence. In 1924 it was banned from medicinal use in the USA when its potential for abuse and addiction was recognized. Diamorphine is used widely and remains the parenteral opioid of choice for the treatment of chronic cancer pain in the UK, but is not used elsewhere because of these concerns.

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